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Meta-Analysis
. 2016 Jun 1;17(6):482-90.
doi: 10.1016/j.jamda.2015.12.092. Epub 2016 Feb 4.

Poor Gait Performance and Prediction of Dementia: Results From a Meta-Analysis

Olivier Beauchet  1 , Cédric Annweiler  2 , Michele L Callisaya  3 , Anne-Marie De Cock  4 , Jorunn L Helbostad  5 , Reto W Kressig  6 , Velandai Srikanth  7 , Jean-Paul Steinmetz  8 , Helena M Blumen  9 , Joe Verghese  9 , Gilles Allali  10
Affiliations
Meta-Analysis

Poor Gait Performance and Prediction of Dementia: Results From a Meta-Analysis

Olivier Beauchet et al. J Am Med Dir Assoc. .

Abstract

Background: Poor gait performance predicts risk of developing dementia. No structured critical evaluation has been conducted to study this association yet. The aim of this meta-analysis was to systematically examine the association of poor gait performance with incidence of dementia.

Methods: An English and French Medline search was conducted in June 2015, with no limit of date, using the medical subject headings terms "Gait" OR "Gait Disorders, Neurologic" OR "Gait Apraxia" OR "Gait Ataxia" AND "Dementia" OR "Frontotemporal Dementia" OR "Dementia, Multi-Infarct" OR "Dementia, Vascular" OR "Alzheimer Disease" OR "Lewy Body Disease" OR "Frontotemporal Dementia With Motor Neuron Disease" (Supplementary Concept). Poor gait performance was defined by standardized tests of walking, and dementia was diagnosed according to international consensus criteria. Four etiologies of dementia were identified: any dementia, Alzheimer disease (AD), vascular dementia (VaD), and non-AD (ie, pooling VaD, mixed dementias, and other dementias). Fixed effects meta-analyses were performed on the estimates in order to generate summary values.

Results: Of the 796 identified abstracts, 12 (1.5%) were included in this systematic review and meta-analysis. Poor gait performance predicted dementia [pooled hazard ratio (HR) combined with relative risk and odds ratio = 1.53 with P < .001 for any dementia, pooled HR = 1.79 with P < .001 for VaD, HR = 1.89 with P value < .001 for non-AD]. Findings were weaker for predicting AD (HR = 1.03 with P value = .004).

Conclusions: This meta-analysis provides evidence that poor gait performance predicts dementia. This association depends on the type of dementia; poor gait performance is a stronger predictor of non-AD dementias than AD.

Keywords: Epidemiology; dementia; gait disorders/ataxia; motor control.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Fig. 1
Fig. 1
Flow diagram of selection of studies. *Ovid EMBASE.
Fig. 2
Fig. 2
Forest plot of pooled estimated HR for risk of incident dementia. (A) Any dementia, (B) AD, (C) non-AD, and (D) VaD in participants with abnormal gait at baseline compared with those with normal gait. Square box area proportional to the sample size of each study; horizontal lines corresponding to the 95% CI; diamond representing the summary value; vertical line corresponding to a HR combined with RR of 1.00, equivalent to no difference.
Fig. 3
Fig. 3
Forest plot of pooled estimated HR pooled with OR for risk of incident of any dementia in participants with abnormal gait at baseline compared with those with normal gait. Square box area proportional to the sample size of each study; horizontal lines corresponding to the 95% CI; diamond representing the summary value; vertical line corresponding to a HR combined with RR and OR of 1.00, equivalent to no difference.
See this image and copyright information in PMC

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